-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, JuXf7/B9KklwfNd+GyxXzhGzRGbk5FNwOdneaGYOxcTtC1WtIzlbmKBY4atrlQNR P51Jc/seYr0K8htFS3TznQ== 0001209191-04-049892.txt : 20041028 0001209191-04-049892.hdr.sgml : 20041028 20041028150211 ACCESSION NUMBER: 0001209191-04-049892 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041026 FILED AS OF DATE: 20041028 DATE AS OF CHANGE: 20041028 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FISCHER HAROLD K CENTRAL INDEX KEY: 0001213165 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03722 FILM NUMBER: 041102410 MAIL ADDRESS: STREET 1: 21 COUSTEAU LN. CITY: AUSTIN STATE: TX ZIP: 78746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATLANTIC AMERICAN CORP CENTRAL INDEX KEY: 0000008177 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 581027114 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4370 PEACHTREE RD NE CITY: ATLANTA STATE: GA ZIP: 30319 BUSINESS PHONE: 4042665500 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD CITY: ATLANTA STATE: GA ZIP: 30319 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-10-26 0 0000008177 ATLANTIC AMERICAN CORP AAME 0001213165 FISCHER HAROLD K 4370 PEACHTREE ROAD, N.E. ATLANTA GA 30319 1 0 0 0 Common Stock 2004-10-26 4 A 0 3333 A 12233 D Common Stock 1329320 D Option to Buy Cmn Stk 1000 1000 D Represents 3333 shares of restricted stock that were awarded pursuant to the Company's 2002 Incentive Plan. No consideration is required to be paid by recipient. Mr. Fischer also has direct ownership interest in 1329320 shares held jointly with spouse. Mr. Fischer also holds options to acquire 1000 shares of common stock granted under the Company's 1996 Non-Employee Director Stock Option Plan at an exercise of $2.68. Janie L. Ryan, POA 2004-10-28 -----END PRIVACY-ENHANCED MESSAGE-----